Device and method for tendon, ligament or soft tissue repair

ABSTRACT

Disclosed are medical devices and methods for tendon, ligament, and soft tissue repair. A method includes introducing a first segment having a delivery assembly into a first soft tissue, and removing the delivery assembly to expose an opening of a hollow body of the first segment. The method also includes introducing a second segment having a second delivery assembly and a second body into a second soft tissue, guiding the second delivery assembly through the opening, and advancing the second body into the hollow body, thereby joining the first soft tissue and the second soft tissue.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a divisional of U.S. application Ser. No.12/273,109 filed Nov. 18, 2008, which claims priority to U.S.Provisional Application No. 61/034,299 filed on Mar. 6, 2008, thecontents of both of which are incorporated herein by reference in theirentirety.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The invention generally relates to medical devices and procedures, andmore particularly to devices and methods for tendon, ligament, and softtissue repair, closure and/or reinsertion.

2. Discussion of Background Information

Conventional methods for tendon, ligament, and soft tissue repair ofteninvolve extensive suturing of the tissue being repaired. For example, inthe case of tendon repair, one known method involves passing a firstsuture into and out of a first portion of the tendon numerous times,resulting in two free ends of the suture extending from the cut end ofthe first tendon portion. A second suture is similarly arranged in asecond tendon portion. The free ends of the first and second sutures aretied (e.g., knotted) together to affix the cut ends of the tendonportions together.

However, such methods have numerous drawbacks. The act of passing thesuture into and out of the tendon (e.g., typically at least six timesper tendon portion) causes trauma to the tendon, thereby increasing thechance for infection. Furthermore repeated trauma to the tendon byexcessive handling may create excessive damage to tendon/ligament/tissuevasculature which may compromise repair. Also, the knots of the suturesartificially increase the dimension of the tendon at the repair site,which creates increased friction at the repair site and/or tendon pulleyinterface. Increased friction at this interface increases theopportunity for tendon failure during loading. Even further, thestrength of the repair is dependent upon the knots, which may slip overtime (e.g., due to surgical error). Conventional suture-based repairmethods may disadvantageously impair the vascularity of the tendon andhave increased tendon diameter at the repair site. Traditional suturerepair requires extensive exposure, manipulation, handling, and needlepenetration of the tendon.

Barbed filaments provide an alternative to knot-based repair techniques.According to known methods, a single barbed filament is passed into andout of the portions of the tendon, thereby drawings the tendon portionstogether. Barbs on the exterior of the barbed filament engage the tendonportions internally, thereby resisting separation of the drawn-togethertendon portions. Repairs using barbed filaments can be knotless, havethe potential for a lower tendon profile at the site of the repair, andhave the potential for equivalent strength when compared to knot-basedrepairs. However, techniques using barbed filaments can be moretraumatic to the tendon than traditional repairs, may increase the riskof infection and/or impair the vascularity of the tendon, and aretechnically demanding.

Accordingly, there exists a need in the art to overcome the deficienciesand limitations described hereinabove.

SUMMARY

According to a first aspect of the invention, there is an apparatus fortissue repair comprising: a hollow body; an anchor at one end of thehollow body; a suture and needle connected to an other end of the hollowbody opposite the anchor; and a second body. The hollow body isstructured and arranged to be inserted in a first tissue comprising oneof a first soft tissue and bone, and the second body is structured andarranged to be inserted in a second soft tissue. Moreover, the secondbody is structured and arranged to be inserted into and held within thehollow body, thereby connecting the first tissue and the second softtissue.

In embodiments, the apparatus further comprises a second anchorconnected to an end of the second body, and a second suture and secondneedle connected to an other end of the second body opposite the secondanchor. In accordance with aspects of the invention, the suture andneedle guide insertion of the hollow body into a sidewall of the firsttissue and out of an end of the first tissue. Moreover, the secondsuture and second needle guide insertion of the second body into asidewall of the second soft tissue, out of an end of the second softtissue, and through the hollow body.

At least one of the hollow body and the second body may comprise pores(e.g., holes) and/or indentations that allow for in-growth of bloodvessels or other connective tissue. In embodiments, the suture andneedle are removable to expose an opening at the end of the hollow body.

The apparatus may further comprise an engagement structure on aninterior of the hollow body. Additionally, the apparatus may include asecond engagement structure on an exterior of the second body, whereinthe second engagement structure corresponds with and engages theengagement structure when the second body is inserted into the hollowbody. The apparatus may also comprise an anti-slipping structure on anexterior surface of the hollow body.

In embodiments, the anchor comprises a flange that is structured andarranged to engage an outer surface of the first soft tissue. The hollowbody may be bent adjacent the anchor. The apparatus may further comprisea sleeve arranged between the second body and the hollow bodyfrictionally securing the second body to the hollow body.

According to another aspect of the invention, there is a method forrepairing soft tissue. The method includes: introducing a first segmentcomprising a delivery assembly into a first soft tissue, and removingthe delivery assembly to expose an opening of a hollow body of the firstsegment. The method also includes introducing a second segmentcomprising a second delivery assembly and a second body into a secondsoft tissue, guiding the second delivery assembly through the opening,and advancing the second body into the hollow body, thereby joining thefirst soft tissue and the second soft tissue.

In embodiments, the removing the delivery assembly comprises cutting thefirst segment so that an opening of the hollow body is substantiallyflush with an end of the first soft tissue. The method may furthercomprise removing the second delivery assembly from the second bodyafter one of: the guiding and the advancing.

In embodiments, the introducing the first segment comprises insertingthe delivery assembly into a sidewall of the first soft tissue, throughan interior of the first soft tissue, and out of an end of the firstsoft tissue. The introducing the first segment may further compriseadvancing the hollow body through the first soft tissue until an anchorat one end of the hollow body engages the first soft tissue.

In accordance with aspects of the invention, the method may furthercomprise securing the first segment to the second segment. The securingmay comprise engaging corresponding engagement structures on an interiorof the hollow body and an exterior of the second body. The securing maycomprise inserting a free end of the second segment into a sleeve, andmoving the sleeve into a friction-fit position between the hollow bodyand the second body. The securing may comprises one of: deforming ormelting corresponding portions of the hollow body and second body usingheat, adhering the hollow body to the second body using adhesive,crimping the hollow body to the second body, and inserting a frictionshim between the hollow body to the second body.

According to another aspect of the invention, there is an apparatus thatconnects and approximates a first soft tissue to a second soft tissue.The apparatus when installed in the first soft tissue and the secondsoft tissue includes a hollow elongate body comprising a first openingat a substantially straight end and a second opening at a bent end,wherein a first plane containing the first opening intersects a secondplane containing the second opening. The apparatus also includes a firstflange integral with the bent end, a second elongate body, a secondflange integral with the second body, and a securing structure.

In an installed state, the hollow elongate body is arranged within thefirst soft tissue with the first flange anchoring the hollow elongatebody in the first soft tissue. In the installed state, the secondelongate body is arranged within the second soft tissue with the secondflange anchoring the second elongate body in the second soft tissue. Inthe installed state, the second elongate body is arranged within thehollow elongate body, and the securing structure restricts motion of thesecond elongate body relative to the hollow elongate body. Inembodiments, the securing structure may comprise, but is not limited to:one or more engagement structures on an interior surface of the hollowbody and an exterior surface of the second body; a sleeve; a shim; acrimped portion; an adhered portion; and a heat deformed or meltedportion.

BRIEF DESCRIPTION OF THE DRAWINGS

The present invention is further described in the detailed descriptionwhich follows, in reference to the noted plurality of drawings by way ofnon-limiting examples of exemplary embodiments of the present invention,in which like reference numerals represent similar parts throughout theseveral views of the drawings, and wherein:

FIGS. 1-11 show elements of a system and method according to aspects ofthe invention.

DETAILED DESCRIPTION OF EMBODIMENTS

The particulars shown herein are by way of example and for purposes ofillustrative discussion of the embodiments of the present invention onlyand are presented in the cause of providing what is believed to be themost useful and readily understood description of the principles andconceptual aspects of the present invention. In this regard, no attemptis made to show structural details of the present invention in moredetail than is necessary for the fundamental understanding of thepresent invention, the description taken with the drawings makingapparent to those skilled in the art how the several forms of thepresent invention may be embodied in practice.

The invention generally relates to medical devices and procedures, andmore particularly to devices and methods for tendon, ligament, and softtissue repair. Exemplary embodiments of the invention comprise twocooperating segments that, after being inserted into respective softtissue portions, engage each other to bring the soft tissue portionsinto contact with one another. According to aspects of the invention,the segments may be inserted into and anchored in the soft tissueportions in a minimally invasive (e.g., atraumatically) mode. Moreover,embodiments of the invention may be used to connect soft tissue to bone,such as, for example, a ligament to bone. In this manner,implementations of the invention provide an effective system and methodfor soft tissue repair that overcome the above-described deficienciesand limitations of the prior art.

FIG. 1 shows a system 10 according to aspects of the invention includinga female segment 20 and a male segment 25 for repairing of soft tissue(e.g., tendon, ligament, skin, etc.). In an exemplary implementation ofthe invention, the female segment 20 is inserted into a first tissueportion 30, and the male segment 25 is inserted into a second tissueportion 35. As depicted in FIG. 2, the male segment 25 may be drawn intothe female segment 20, which draws the tissue portions 30, 35 together.FIG. 3 shows the system 10 in a substantially completed repair position,in which female segment 20 and male segment 25 are engaged such that thefirst tissue portion 30 and second tissue portion 35 abut one another atan interface 40.

FIG. 4 shows further details of an exemplary female segment 20 accordingto aspects of the invention. In embodiments, the female segment 20includes a hollow body 50 made of permanent (i.e., not absorbed by thebody) or bio-absorbable material. Non-limiting examples of permanentmaterial include plastic, nylon, etc. Non-limiting examples ofbio-absorbable include monocryl, polydioxanone (PDS), etc. However, theinvention is not limited to these examples, and any suitable materialsmay be used for forming the male and female segments. Moreover, eachsegment may be composed of a combination of different materials.

The female segment 20 further includes a delivery system at one end ofthe hollow body 50. The delivery system comprises a curved needle 52swaged to one end of a suture 55. An opposite end of the suture 55 isintegrally connected to an introducer wedge 60. The introducer wedge 60may be in the shape of a cone (although other shapes may be used), andfunctions as a delivery wedge for atraumatically introducing the femalesegment 20 into soft tissue (e.g., tendon, ligament, etc.). Inembodiments the introducer wedge 60 is solid and its base hassubstantially the same diameter as the outer diameter of the hollow body50. The introducer wedge 60 is affixed to the hollow body 50, forexample, via a seamless connection. The introducer wedge 60 may be madeof the same material as the hollow body 45, or alternatively may be madeof a different material. As discussed herein, the introducer wedge 60 isconfigured to be cut from the hollow body 45, and the introducer wedge60, curved needle 52, and suture are referred to as a removable deliveryassembly.

In one embodiment, the hollow body 50 includes at least one structure 67on its interior surface for engaging the outer surface of the malesegment 25. The structure 67 may comprise, for example, ridges, teeth,roughening, knurling, protrusions, indentations, etc. The structure 67may be arranged at any desired location along the interior of the hollowbody 50. Moreover, plural instances of the structure 67 may be locatedthroughout the hollow body 50, for example, at regularly spaced(predetermined) intervals. In one example, a single structure 67 isarranged at one end of the hollow body 50, although the invention is notlimited to this arrangement.

In an alternative embodiment, the hollow body 50 has a substantiallysmooth inner surface. In this embodiment, the female segment 20 engagesthe male segment 25 by way of a security cap and/or through the use ofan adhesive, described in greater detail below.

Still referring to FIG. 4, the hollow body 50 may be provided with oneor more protrusions 69 (e.g., anti-slipping structure) on its exteriorsurface. The protrusions 69 allow the female segment 20 to better adhereto the inner surface of the soft tissue into which it is inserted. Theprotrusions 69 may comprise, for example, ridges, teeth, roughening,knurling, protrusions, indentations, etc.

An end of the hollow body 50 opposite the introducer wedge 60 isprovided with an anchor 70. The anchor 70 is a continuation of thehollow body 50 and comprises a flange 75 that is structured and arrangedto reside outside or inside the soft tissue when the system is installed(see FIG. 5). The anchor 70 may be integral with the hollow body 50(e.g., integrally formed via a molding manufacturing process). Theanchor 70 has a hole though it which is a continuation of the interiorportion of the hollow body 50. The anchor 70 is angled appropriately inrelation to the hollow body 50 so that as tension is loaded on thesystem 10, the anchor 70 will remain low profile (with respect to thesurface of the tendon) so as not to interfere with any pulley systemassociated with the tissue (e.g., a tendon pulley). For example, a planeof the flange 75 may be angled with respect to the longitudinal axis ofthe hollow body 50. As another example, a first plane containing theopening of the hollow body at the flange may be non-parallel to (e.g.,intersecting with) a second plane containing the opening of the hollowbody at the end opposite the flange. The angle may be provided, forexample, by a bend 80 in the hollow body 50.

In embodiments, the anchor 70 functions to provide support forlongitudinal, horizontal, and angular forces placed on thetendon/ligament system as it is loaded. The anchor 70 may or may nothave small areas by which it may be sutured to the soft tissue. Forexample, the flange 75 may comprise one or more holes through which asuture may be passed. Additionally or alternatively, the anchor may becomposed of a material that a suture can be inserted through without apre-formed hole (e.g., pierced). The flange 75 may be any desired shapeand configuration depending on the tissue, location, and anticipatedload level (e.g., forces to be withstood). The anchor 70 may be made ofthe same material as the hollow body 50.

FIG. 6 shows further details of an exemplary male segment 25 accordingto aspects of the invention. In embodiments, the male segment 25includes a solid body 80. Like the female segment 20, the male segment25 includes a delivery system (e.g., removable delivery assembly)comprising a needle 85, suture 90, and introducer wedge 95. Theintroducer wedge 95 may comprise a solid cone, the base of which isaffixed to an end of the solid body 80. At an opposite end of the solidbody 80 is an anchor 100. In embodiments, the needle 85 is a curvedtapered needle that is swaged to one end of the suture 90. Another endof the suture is integrally formed in (e.g., molded or melted into) anend of the introducer wedge 95. Moreover, the diameter of the base ofthe introducer wedge 95 equals the outer diameter of the solid body 80.The solid body 80, introducer wedge 95, and anchor 100 may be made ofany of the aforementioned materials (or combinations of materials)described with respect to the hollow body 50.

In one embodiment, at least one engagement structure 107 is arranged onthe external surface of the solid core 80 (see FIG. 7). The engagementstructure 107 may comprise, for example, ridges, teeth, roughening,knurling, protrusions, indentations, etc. The structure 107 may bearranged at any desired location along the interior of the solid body80. Moreover, plural instances of the structure 107 may be locatedthroughout the solid body 80, for example, at regularly spaced(predetermined) intervals. In one example, a single structure 107 isarranged at one end of the solid body 80, although the invention is notlimited to this arrangement.

In embodiments, when the male segment 25 is inserted into the femalesegment 20 in a first direction, structure 107 engages structure 67 toprevent the male segment 25 from being removed out of the female segment20 (e.g., in a second direction opposite the first direction). Ifmultiple instances of structure 67 and/or structure 107 are used, then aratchet-type connection can be made. That is, the male segment 25 can beinserted into the female segment 20 a little bit at a time, until aprecise spatial relationship between the respective soft tissue parts isobtained.

In an alternative embodiment, the exterior surface of the solid body 80is smooth. In this embodiment, the female segment 20 engages the malesegment 25 by way of a security cap and/or through the use of anadhesive, described in greater detail below.

The anchor 100 of the male segment 25 is similar to the female segment,however, there is no hole in the middle. Instead, the anchor 100 issubstantially solid and is positioned at an appropriate angle to reducethe overall extratendinous and/or intratendinous profile of the system10. Like the anchor of the female segment, the anchor 100 may be of anysuitable size and shape, and may provided with holes for suturing.

In an exemplary method according to aspects of the invention, the cuttendon, ligament, or tissue ends are freshened with a scalpel tooptimize repair. The female needle 52 and suture 55 are deliveredintratendinous (e.g., inserted into the sidewall of the tendon) startingat a distance of about one centimeter from the cut edge of the tissue.The needle 52 and suture 55 are passed through the interior of thetissue and passed out of the cut end of the tissue. After the suture 55has been introduced in this manner, the introducer wedge 60 is pulled,using the suture 55, into and through the tendon or tissue with steadypressure until the anchor 70 engages the tendon or tissue and stopsfurther advancement of the female segment 20. At this point, the femalesegment 20 is arranged in the tissue 30 as depicted in FIG. 1.

The female segment 20 may be cut flush in the plane of the tissue 30,for example as depicted at line 125 shown in FIG. 1. This cuttingremoves the introducer wedge 60, suture 55, and needle 52 from thehollow body 50. A portion of the hollow body 50 may also be removed bythe cut, depending upon how far the female segment extends out of thetissue. This cutting exposes the hollow inner portion of the hollow body50.

To deliver the male segment 25 into the other portion of 35 of the cuttissue, the male needle 85 and suture 90 are delivered in the tissue 35in a manner similar to the delivery of the female needle and suture(e.g., inserted into the sidewall of the tissue about a centimeter backfrom the cut of the tissue). The needle 85 is extended out of the middleof the cut end of the tissue, and the suture 90 is pulled with steadypressure to pull the introducer wedge 95 and solid body 80 into thetissue 35. The solid body is pulled through the tissue 35 until the maleanchor 100 engages the tissue and prevents further advancement. In thisway, the male segment 25 is arranged in the tissue 35 as depicted inFIG. 1.

The needle 85 is removed, e.g., cut off of the suture 90, leaving a freeend of the suture 90. The free end of the suture 90 is passed in aretrograde fashion through the exposed hollow body 50. Morespecifically, the free end of the suture 90 is inserted into theinterior of the hollow body 50 at the cut 125. The free end of thesuture 90 is advanced through the interior of the hollow body 50 untilthe free end of the suture 90 exits through the hole in the anchor 70.During, or after, this advancement of the free end of the suture 90, thecut ends of the tissue 30, 35 are approximated and the introducing wedge95 is inserted into the interior of the hollow body 50 at the cut 125,as depicted in FIG. 2.

Pulling the free end of the suture 90 advances the solid body 80 intothe hollow body 50. In one embodiment, advancement of the solid body 80into the hollow body 50 causes structure 107 to engage structure 67,which prevents the male segment 25 from backing out of the femalesegment 20. When plural structures 107 and/or structures 67 areemployed, the solid body 80 may be advanced in a ratchet-like fashioninto the hollow body 50.

The male segment 25 is advanced into the female segment 30 until the cutends of the tissue are well approximated and secure (see, e.g., FIG. 3).In some embodiments, a portion of the introducing wedge 95 and even thesolid body 80 may extend out of the hole in the anchor 70. Any portionof the male segment 25 extending from the hole in the anchor 70 is cutaway, such that the male segment 25 is flush with the female anchor 70to give the system the lowest profile possible on the tissue surface tominimize interference (e.g., with a pulley associated with the tendon).

The invention is not limited to the exemplary method described herein.Instead, different processes may be practiced within the scope of theinvention. For example, additional steps may be added, steps may beperformed in a different order, etc.

In further embodiments, following cutting of the male segment 25, theend of the male segment 25 and the female anchor 70 may be additionallysecured using a heat (e.g., to deform or melt at least one of the malesegment and female anchor 70), adhesive (e.g., to adhere the malesegment 25 and the female anchor 70), or by inserting a shim or wedgebetween the male segment 25 and the female anchor 70.

An additional system for securing the male segment 25 to the femalesegment 20 is shown in FIGS. 8-11. In this embodiment, a cap 200sheathed over the free end of the male segment 25 that extends from thehole of the female anchor 70. The cap 200 may comprise, for example, ahollow cylindrical body that is slightly larger than the outer diameterof the solid body 80, and slightly smaller than the inner diameter ofthe hole at the female anchor 70. The cap 200 may further include aflange 205 of any suitable size and shape.

While the free end of the male segment 25 extends from the hole of theanchor 70 (e.g., before cutting), the cap 200 is slid over the free endof the male segment 25. The cap 200 is slid down the male segment 25until an end of the cap 200 is advanced between the exterior of the malesegment 25 and the interior of the hollow body 50. In this manner, thecap 200 acts as a wedge or shim that holds the male segment 25 in placeby friction fit. The flange 205 prevents the cap from being pulled intothe hollow body 50, should forces exerted on the male segment 25 exceedthe friction fit.

The cap 200 can be used in addition to, or as an alternative to, theengagement structures 67, 107. After the cap 200 is set in place betweenthe male segment 25 and the hollow body 50, the excess portion of themale segment 25 is cut flush with the female anchor portion 70.Optionally, the cap may be further secured by crimping (e.g., deformingat least one of the flange 205 and the flange 75), melting, or byapplying adhesive (e.g., inserted between the male segment 25 and thecap 200 and/or between the cap 200 and the hollow body 50).

In further embodiments, at least one of the solid body 80 and hollowbody 50 may be provided with pores (e.g., holes) and/or indentationshaving dimensions suitable to allow for ingrowth of blood vessels orother connective tissue into the system 10 to improve anchoring of thebodies within the soft tissue. The pores and/or indentations may becreated by laser or other suitable device or manufacturing method.

The male and female segments may be sized to any suitable dimension. Inone exemplary implementation of the invention, the female segment hollowbody has an outer diameter of about 1 mm to about 3 mm, and the devicehas a total length of about 3 cm. However, the invention is not limitedto these values, and any suitable dimensions may be used.

In yet further embodiments, at least one of the solid body 80 and hollowbody 50 may be immunologically or chemically enhanced to regulate,modify, or supplement tendon, ligament, or soft tissue healing. Forexample, at least one of the solid body 80 and hollow body 50 may becoated or impregnated with growth hormone, antibiotic, etc.

According to additional aspects of the invention, portions of the maleand female segments 20, 25 are flexible and soft, yet retain theirprefabricated shape. For example, the hollow body 50, solid body 80,introducer wedges 60, 95, and anchors 70, 100 may be made of thermosetmaterial that is soft and flexible yet retains its shape after beinginitially formed.

According to even further aspects of the invention, reinforcing fiberscan be added to, or included in, at least one of the solid body 80 andhollow body 50. Such fibers may be incorporated into the elements of thesystem to provide structural reinforcement.

In accordance with further aspects of the invention, embodiments may beused to connect soft tissue to bone. For example, a hollow body 50 maybe passed through a drill hole in bone, and a solid body 80 may beinserted into a soft tissue and then inserted into the hollow body 50.In this manner, embodiments of the invention may be used to restore aligament-bone relationship.

In accordance with the soft tissue to bone implementation, a method maycomprise: drilling a hole through a bone; inserting the deliveryassembly of a hollow body through the hole in the bone; advancing thehollow body into the hole in the bone; and removing the deliveryassembly to expose an opening of the hollow body. The method may furthercomprise steps similar to those already described herein, such as, forexample: introducing and advancing a solid body into a soft tissue;passing a delivery assembly of the solid body through the hollow body;and advancing the solid body into the hollow body. In this manner,implementations of the invention provide a method for securing softtissue to bone.

It is noted that the foregoing examples have been provided merely forthe purpose of explanation and are in no way to be construed as limitingof the present invention. While the present invention has been describedwith reference to an exemplary embodiment, it is understood that thewords which have been used herein are words of description andillustration, rather than words of limitation. Changes may be made,within the purview of the appended claims, as presently stated and asamended, without departing from the scope and spirit of the presentinvention in its aspects. Although the present invention has beendescribed herein with reference to particular means, materials andembodiments, the present invention is not intended to be limited to theparticulars disclosed herein; rather, the present invention extends toall functionally equivalent structures, methods and uses, such as arewithin the scope of the appended claims.

What is claimed:
 1. A method for repairing soft tissue, comprising:introducing a first segment comprising a hollow body and a deliveryassembly into a first soft tissue, wherein the delivery assemblycomprises a first suture and a first needle at a first end of the hollowbody, and the first segment comprises a first flange at a second end ofthe hollow body; removing the delivery assembly to expose an opening ofa hollow body of the first segment; introducing a second segmentcomprising a second delivery assembly and a second body into a secondsoft tissue, wherein the second delivery assembly comprises a secondsuture and a second needle at a first end of the second body, the secondsegment further comprises a second flange at a second end of the secondbody, and the second body comprises a solid elongate body; guiding thesecond delivery assembly through the opening; and advancing the secondbody into the hollow body, thereby joining the first soft tissue and thesecond soft tissue.
 2. The method of claim 1, wherein the removing thedelivery assembly comprises cutting the first segment so that an openingof the hollow body is flush with an end of the first soft tissue.
 3. Themethod of claim 1, further comprising removing the second deliveryassembly from the second body after one of: the guiding and theadvancing.
 4. The method of claim 1, wherein the introducing the firstsegment comprises: inserting the delivery assembly into a sidewall ofthe first soft tissue, through an interior of the first soft tissue, andout of an end of the first soft tissue; and advancing the hollow bodythrough the first soft tissue until the first flange at one end of thehollow body engages the first soft tissue.
 5. The method of claim 1,further comprising securing the first segment to the second segment. 6.The method of claim 5, wherein the securing comprises engagingcorresponding engagement structures on an interior of the hollow bodyand an exterior of the second body.
 7. The method of claim 5, whereinthe securing comprises: inserting a free end of the second segment intoa sleeve; and moving the sleeve into a friction-fit position between thehollow body and the second body.
 8. The method of claim 5, wherein thesecuring comprises one of: deforming or melting corresponding portionsof the hollow body and second body using heat; adhering the hollow bodyto the second body using adhesive; crimping the hollow body to thesecond body; and inserting a shim between the hollow body to the secondbody.
 9. The method of claim 1, wherein: the delivery assembly includesan introducer wedge connected to the first end of the hollow body, thefirst suture connected to the introducer wedge, and the first needleconnected to the first suture; and the introducing the first segmentcomprises: inserting the delivery assembly into a sidewall of the firstsoft tissue, through an interior of the first soft tissue, and out of anend of the first soft tissue; and advancing the hollow body through thefirst soft tissue until the first flange at the second end of the hollowbody engages an outer surface of the sidewall of the first soft tissue.10. The method of claim 9, wherein: the second body comprises the solidelongate body with the second delivery assembly connected to a first endof the solid elongate body and the second flange at a second end of thesolid body; and the introducing the second segment comprises: insertingthe second delivery assembly into a sidewall of the second soft tissue,through an interior of the second soft tissue, and out of an end of thesecond soft tissue; and advancing the solid body through the second softtissue until the second flange at the second end of the solid bodyengages an outer surface of the sidewall of the second soft tissue. 11.The method of claim 10, wherein: the second delivery assembly comprises:a second introducer wedge connected to the first end of the solidelongate body, the second suture connected to the second introducerwedge, and the second needle connected to the second suture; the guidingthe second delivery assembly through the opening comprises: insertingthe second suture into the opening of the hollow body of the firstsegment; and the advancing the second body into the hollow bodycomprises: passing the the second suture completely through the hollowbody, and pulling the solid body into the hollow body by pulling thesecond suture.
 12. The method of claim 9, wherein the removing thedelivery assembly to expose the opening of the hollow body of the firstsegment comprises: cutting the introducer wedge from the first end ofthe hollow body such that the opening of the hollow body is flush withthe end of the first soft tissue.
 13. A method for repairing softtissue, comprising: introducing a first segment into a sidewall of afirst soft tissue and out an end of the first soft tissue, wherein thefirst segment comprises: a hollow body, a first suture and a firstneedle at a first end of the hollow body, and a first anchor at a secondend of the hollow body; after the introducing the first segment,exposing an opening at the first end of the hollow body by removing thefirst suture and the first needle from the hollow body; introducing asecond segment into a sidewall of a second soft tissue and out an end ofthe second soft tissue, wherein the second segment comprises: a solidbody, a second suture and a second needle at a first end of the solidbody, and a second anchor at a second end of the solid body; insertingthe second suture into the exposed opening at the first end of thehollow body; advancing the second suture through an interior of thehollow body and out a second opening of the hollow body at the secondend of the hollow body; and advancing the solid body into the hollowbody by pulling the second suture, thereby joining the first soft tissueand the second soft tissue.
 14. The method of claim 13, wherein theintroducing the first segment comprises: passing the first suture andthe first needle into the sidewall of the first soft tissue, through aninterior of the first soft tissue, and out of the end of the first softtissue; and advancing the hollow body through the first soft tissue bypulling at least one of the first suture and the first needle until thefirst anchor at the second end of the hollow body engages an outersurface of the sidewall of the first soft tissue.
 15. The method ofclaim 13, wherein the introducing the second segment comprises: passingthe second suture and the second needle into the sidewall of the secondsoft tissue, through an interior of the second soft tissue, and out ofthe end of the second soft tissue; and advancing the solid body throughthe second soft tissue by pulling at least one of the second suture andthe second needle until the second anchor at the second end of the solidbody engages an outer surface of the sidewall of the second soft tissue.16. The method of claim 13, further comprising securing the firstsegment to the second segment.
 17. The method of claim 16, wherein thesecuring comprises engaging corresponding engagement structures on aninterior of the hollow body and an exterior of the solid body during theadvancing the solid body into the hollow body.